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dc.contributor.authorThirunavukarasu, Arun J
dc.contributor.authorHassan, Refaat
dc.contributor.authorSavant, Shalom V
dc.contributor.authorHamilton, Duncan L
dc.date.accessioned2022-06-29T19:49:33Z
dc.date.available2022-06-29T19:49:33Z
dc.date.issued2022-09
dc.date.submitted2022-03-01
dc.identifier.issn1530-7085
dc.identifier.otherpapr13138
dc.identifier.otherppr-2022-0111.r1
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/338589
dc.description.abstractBACKGROUND AND AIMS: Premature neonates require regular ophthalmological examination, generally indirect ophthalmoscopy, to screen for retinopathy of prematurity (ROP). Conventional analgesia is provided with topical anesthetic eyedrops and oral sugar solution, but neonates still experience significant pain. Here, the literature base was examined to evaluate the usefulness of other pharmacological analgesics. MATERIALS AND METHODS: A systematic review was undertaken, adhering to a PROSPERO preregistered protocol in accordance with PRISMA guidelines (identifier CRD42022302459). Electronic databases were searched for primary research articles on pharmacological pain interventions used for ROP screening in neonates. The primary outcome measure was pain scores recorded using validated pain scoring tools, with and without pharmacological interventions in neonates during eye examination. For analysis, studies were separated into two categories: topical anesthesia and alternative pharmacological treatments. RESULTS: Eleven studies met the inclusion criteria. Topical analgesia, oral paracetamol, and intranasal fentanyl were found to be effective in reducing the pain of eye examination. Oral morphine and inhaled nitrous oxide had no significant effect on premature infant pain profile (PIPP) scores during indirect ophthalmoscopy. DISCUSSION: In addition to topical anesthesia, premedication with oral paracetamol is recommended during screening examination for ROP. The routine use of fentanyl is not recommended due to the risk of potential side effects. Non-pharmacological measures, such as sweet oral solutions and comfort techniques should also be employed. Further research is required to determine whether the use of nitrous oxide has a role, and to develop a safe and effective analgesic strategy to fully ameliorate the pain of ROP screening.
dc.languageen
dc.publisherWiley
dc.subjectREVIEW
dc.subjectREVIEWS
dc.subjectanalgesic
dc.subjecteye examination
dc.subjectindirect ophthalmoscopy
dc.subjectneonatal
dc.subjectnitrous oxide
dc.subjectopioids
dc.subjectparacetamol
dc.subjectretinopathy of prematurity
dc.subjectscreening tools
dc.subjecttopical anesthesia
dc.titleAnalgesia for retinopathy of prematurity screening: A systematic review.
dc.typeArticle
dc.date.updated2022-06-29T19:49:33Z
prism.publicationNamePain Pract
dc.identifier.doi10.17863/CAM.86002
dcterms.dateAccepted2022-05-31
rioxxterms.versionofrecord10.1111/papr.13138
rioxxterms.versionAO
rioxxterms.versionVoR
rioxxterms.licenseref.urihttp://creativecommons.org/licenses/by/4.0/
dc.contributor.orcidThirunavukarasu, Arun J [0000-0001-8968-4768]
dc.contributor.orcidSavant, Shalom V [0000-0002-8464-5708]
dc.contributor.orcidHamilton, Duncan L [0000-0003-2132-4867]
dc.identifier.eissn1533-2500
cam.issuedOnline2022-06-27


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